Estimated folic acid intakes from simulated fortification of the New Zealand food supply

Aim: To identify a folic acid food fortification programme that will maximise the percentage of women of child-bearing age receiving at least 400 μg folic acid/day, the amount shown to reduce the risk of neural tube defect-affected pregnancies, while not putting population groups at risk of excessive intakes. Methods: 1997 New Zealand National Nutrition Survey data and a computer modelling programme were used to estimate folic acid intakes from simulated fortification scenarios. Results: Breads fortified with folic acid at 150 μg/50 g, white flour at 100 μg/35 g and liquid milk at 200 μg/200 ml, were found to be the best fortification scenarios. Thirty one percent, 21% and 18% of women of child-bearing age received =400 μg folic acid/day from the fortification of bread, white flour and milk respectively. Conclusions: The most effective scenario for folic acid fortification is bread fortified at 150 μg/50 g. However, it is impossible to fortify food at a level that ensures the majority of women of child-bearing age receive more than 400 mg folic acid/day without exposing some people to excessive amounts of folic acid. The current public health message encouraging women to select folic acid fortified foods and take folic acid supplements, needs to continue.